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Class Registration Form

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Parent or Gaurdians Name: *

Address: *

Home and Mobile number: *

E-mail address: *

Class or classes I am interested in: *

Student Name: *

Student Age and DOB:

Name of School or nursery: *

Does the student have any allergies or condition which requires medical treatment on a regular basis? please specify: *

Is there anything else we should be aware of?

I agree to my child receiving emergency medical treatment, including anaesthetic, as considered necessary by the medical authorities present.

Emergency Contact Name: *

Relationship to student: *

Home and Mobile number:

Promotional pictures and videos may be taken during LMPA classes and events; we will require a written request if you do not wish for your child to take part.

Captcha (spam protection code): *

I agree that my data entered in this form will be stored electronically by LMPA Academy and a hard copy will also be with class teacher where appropriate. I am aware that I can revoke my consent and also request to have my details deleted at any time.

Note: Fields marked with * are required

Contact LMPA

07763473886

Lorayne@LMPerformingArts.com

Or use our contact form

LMPA Facebook Page

ALL PHOTO CREDITS TO

Rosie Woodhouse

LOVE SKYE PHOTOGRAPHY

Wild and romantic adventure elopement and wedding photography on the Isle of Skye For those who adventure

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